Neuropathic pain may be reduced with minocycline. These narrative review results were published in the Journal of Pain Research.
Researchers from 3 universities in South Korea searched publication databases for articles (N = 9) on minocycline and neuropathic pain through January 2021. The studies included in this review included 232 people who were given minocycline for pain in randomized clinical trials (n = 7) or prospective observational studies (n = 2).
In patients with chemotherapy-induced neuropathy, 2 studies showed a positive effect and 1 study showed no effect. A positive effect was reported in a study of patients (n = 22) with breast cancer who received minocycline 100 mg twice daily for 12 weeks. These patients reported less pain and used less opioid medication.
Another positive effect was found in patients (n = 19) with non-small cell lung cancer who received chemoradiotherapy for 6 to 7 weeks. Those who received minocycline 100 mg twice daily had significantly less pain, fatigue, and shortness of breath. In the last study, patients (n = 32) with locally advanced or metastatic colorectal cancer who received 100 mg twice daily for 4 months reported no beneficial effects.
Patients with lumbar pain reported either a positive or no effect. Patients (n = 43) with radicular pain in the lumbar spine who had received minocycline for 8 days at the time of the operation did not report any improvement in pain compared to participants in the control group when asked 3 months later. Patients (n = 17) with subacute radicular pain in the lumbar spine reported a positive effect (1.47-point pain reduction) after 100 mg minocycline for 2 weeks. The positive effect was found to be of little clinical importance.
Minocycline appeared to be ineffective for treating the carpal tunnel in 43 patients who underwent surgery. They received 200 mg of the drug 2 hours before surgery and then 100 mg twice a day for 5 days.
A reduction in pain was reported by patients (n = 25) with diabetic neuropathy. After 6 weeks, 100 mg minocycline twice a day, the pain measured on the visual analog scale was reduced from 6.7 to 2.9.
Patients (n = 11) who took 100 mg minocycline daily for 3 months for their leprosy neuropathy reported a pain reduction of 75% or more, and all but 2 patients also showed functional improvement.
A study involving patients with various causes of neuropathic pain found that after 4 weeks of escalating doses of minocycline from 100 mg to 200 mg, the pain was moderately reduced from 5.6 to 5.3.
No study reported negative side effects.
These data suggest that some patients with neuropathic pain, particularly those with leprotic neuropathy or diabetic neuropathy, may benefit from minocycline therapy with a low risk of side effects.
Shin DA, Kim TU, Chang MC. Minocycline for the Control of Neuropathic Pain: A Systematic Narrative Review of Human Studies. J Pain Res. 2021; 14: 139-145. doi: 10.2147 / JPR.S292824
This article originally appeared on Clinical Pain Advisor